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Hello,
We have a cat who has been sneezing, making noise when breathing, and has had discharge (sometimes bloody) from a nostril. She has had these symptoms for several months and they seem to be getting worse. Our regular vet has treated our cat with antiviral, antibiotic, and steroid medications. The medications have not helped.They are not sure of the cause of these symptoms, but a visiting vet suggested our cat may have nasal polyps. We were referred to a specialist vet who suggested testing (biopsy, CT scan, X-ray) with a quoted price of $8,000, which is more than we can afford. We saw your video on nasal polyps and wanted to see if you are able to help us and our cat, Koshka. Thank you very much!
My 13 yr old feline, DLH with multiple teeth cleanings and extractions started sneezing Fall 2023. My vet recommended Lyseine, which has helped. She had another teeth cleaning and single extraction Nov 2024. This weekend she began sneezing multiple times a day and now has runny eyes. I would also swear her lips are inflamed around her whiskers. I contacted the vet and we will try an antibiotic. What else should I do to assist? I am getting a humidifier and will keep her in my bathroom when I shower each day. Should I change her litter type? They both currently use Dr. Elyse Attract Long Hair. Obviously if the antibiotic doesnt work I will take her back in for further examination, Thank You!
Hello,
Sorry for the delay. Sneezing has lots of possible causes. And therefore it is very hard to diagnose the cause so we can best direct a treatment plan.
I think your plan sounds pretty solid. I would start w your suggestions and see the vet.
best of luck
Colin to Dr. Krista : May I pick your Brains?
Dear Dr. Krista,
I’m writing to ask your advice about a stray cat I found last month. See images attached.
But first I want to thank you for the polyp videos you made, which were refreshing, as well as impressive.
One of my strays was snoring, so I was eager to pluck out a polyp hiding behind his soft-palate. (He didn’t have one, but I’m gratefully alerted for the future.)
Last month I found a stunted stray ginger cat outside a 7/11 in North Thailand, where I’m a self-financed Christian missionary.
Can you help me diagnose, and treat the problem?
At first I thought it was simply FVR / Calici and chronic snuffles.
But when I opened her mouth, she had only 4 teeth in her head!
Yes, she had calici tongue-ulcers, but little sneezing, no ocular discharge, and has been eating like a horse from day one. She’s happy and bright in herself, apart from the ugly sore nose.
Her mandibular Ln were big and hard, so I put her on antibiotic tablets, with a little dexamethasone (actually 2.5mg Prednisolone tab. daily.)
Then after a week or so I sedated her, and examined her mouth more closely, no observable polyps (drat!) but one of her molars was loose and covered in calculus, so I pulled that one out, and cleaned up the remaining molar and two premolars, otherwise the poor thing would have zero teeth.
There was of course gingivitis and pharyngitis, but pink, not red like “dragon-mouthed cats” on dcf.
For the last month I’ve given her a course of floxacilin (30 days) with amoxycillin, and tried all sort of creams on her nose and lower eyelids which. as you can see, are raw and sore.
Her Ln are almost normal now, +but that nose is no better+, and she tries to rub as though it is itchy.
(I made up creams mixing; 10% flours of sulphur, betamethasone, ivermectin, and vaseline)
There’s a temporary lessening at best, but no lasting improvement.
So what is your differential for her?
In NZ where I locummed, cat leprosy was common (Mycobacterium from mice and voles) so that was my diagnosis, but the floxacillin has made no impression.
I’ve trimmed her claws and taped her fore paws to stop her making her nose raw.
I’m stuck, and thought of asking you Doc.
I’d guess she’s 3-4 years old, confident, unvaccinated, entire, lived wild all her life eating left over fast food, and possibly DCF from neighbours.
Since October I’ve been feeding her raw chicken frames, tinned sardines, vitamin syrup, and no DCF.
She loves raw chicken :), and eats whatever I put in front of her and still looks for more.
Apart from her nose you would not think she was ill in any way.
Thanks for your advice.
Colin
PS. For some reason, Depo-medrone has been taken off the market here, not even local vets can get hold of it.
Colin Melbourne English missionary in Asia
https://www.born-again-christian.org/news/
https://www.born-again-christian.org/news/ไทยคริสเตียน/
https://www.born-again-christian.info/aboutus.htm
https://www.born-again-christian.com (Asian languages)
Hello!
Thank you for helping this kitty.
I am happy to help, but a few things are important to remember; I do not know all of the local diseases to your area. We live in very different places and animals get exposed to different diseases in different places.
Based on the history and response to treatment so far I think the antibiotic was warranted and may need to be provided every so often to manage secondary infections due to severity of the cats condition.
I also think that there is a chance this could be one of the following:
Infection (fungal or bacterial)
Immune mediated (pemphigus/lupus)
Or cancer (squamous cell, etc)
To diagnose these you may need biopsy or cytology. I would try to resist treating without some ability to rule something out. (Steroids and fungal infections can make things worse).
Please keep us posted. Very best of luck.
Krista.
Dear Dr. Krista,
Thank you for your quick response 🙂
Yes, I’m aware of the dangers of cortisone therapy, but living in the mountains, I’m limited to kitchen table surgery 🙂
I do also liaise with a kind local lady-vet, who supplies me with whatever medicines I need.
She too is stumped, and I’ve been here three decades plus +and never seen anything like it before.+
I tried mixing miconazole in with the various creams I concocted, like you concerned it could be a fungal disease. But I find flours of sulphur cures both mange and ringworm here, if applied gently and persistently enough.
Yes, the spectre of Squamous cell carcinoma looms, but she is remarkably bright and active.
Almost no sneezing or nasal discharge.
The “Rodent ulcers” that I’ve seen look different, and usually just the lips, and the ulcer has a thickened rolled edge: This one is different.
+Doc., have YOU seen anything like this before?+
I should mention, she had a lick granuloma on her hip, but that has healed now, with flea-bathing, and the steroids she’s been on. (I don’t like using fipronil, ie. “Poison your pet to poison its parasites”. Not a sound strategy.)
Can you ask around for me please if any of your colleagues have seen a nose like that, despite over a month intensive blunderbuss therapy? Feel free to post the images on a specialised dermatology group if you know of one.
Colin
Dear Dr. Krista,
Thank you for your comments. Your mention of locality sparked a line of new thoughts.
Most of my vet jobs have been in the tropics (Jamaica, Arabia, Singapore etc) where venomous creatures are commonplace (Toads, insects, scorpions, spiders, centipedes, and snakes).
I’ve seen Arabian horses lamed by a centipede bite, a rare Arabian Oryx die from a snake bite.
One characteristic symptom I’ve noticed in cats of spider bites is intense, frantic licking of the cat’s body. It is continuous until the toxin effect subsides after a few hours, so mild sedation is called for. It’s clinically distinct from the CNS effects of agricultural toxins.
This cat has lived around a 24 hour 7/11 shop, and the bright lights at night attract swarms of termites and beetles: Cats love eating termites, +but so do; scorpions, snakes, spiders, centipedes, and toads+ that live in drains.
Just this week, my other strays brought two live snakes as “love gifts”, one was a harmless Tree-snake, the other a 60cm Red-necked Keelback (small, but whose venom is nonetheless as deadly as the Banded-Krait’s!) (See attached snap I took of “Chatty” offering a cute-little Keelback present to me.)
https://thailandsnakes.com/red-necked-keelback-venomous-mildly-dangerous/
Doctor Krista, It’s possible what we are looking at is a cat recovering from a bite, or sting, on the left nostril by a snake, scorpion, hornet, spider etc.
I know from personal experience that such wounds provoke Type 4 cell-mediated immune responses, (cf. acute inflammatory antibody responses) and so are very slow to heal. (My neighbour was blinded in one eye by reaction to a Hornet sting.)
With neoplasia, I’d expect this cat to be inappetent and “ill”, but she’s bright, eating well, and purring loudly by my side as I type. So I’m leaning to the insect, arachnid, snake bite, or sting idea for now.
It’d be nice to have the luxury of lab-work and histology, if it were available and reliable, but I’m old-school trained, and content diagnosing on sensory data alone.
I certainly considered your Pemphigus differential, but she would have responded very well to the prednisolone 2.5mg/day according to this paper and others:
https://www.veterinary-practice.com/article/feline-pemphigus-foliaceus
Thank you for helping me brainstorm 🙂
I will update you on her recovery.
Colin
“Princess” : 15th. March 2025, five month update…
See attached snap of her after five months, off the street, and in my care.
“That nasal ulceration doesn’t look any better!” You reply, and I have to agree, it’s very frustrating.
She is still happy, bright, and eating every meal I present her with.
She’s tiny, but the Top-Cat of my six strays.
When stared at by another feline, she stares back silent & unblinking, and if eye-contact is maintained, she gives a paw-slap to the cheeky chappie, as if to say, “You do NOT stare at a Princess like that you commoner!”
The flea season has begun here in the tropics, so I shampoo her weekly, and rinse with Carbaryl 5% flea and tick powder. She enjoys the soothing effect of shampoo and warm water, and then after a rub down with a towel, frolics in the garden to dry out quickly.
The only medication I’m using is 2.5mg of prednisolone tablets every few days according to how irritated she is by the sore nose. A serous fluid runs from it occasionally, but isn’t continuous. She sneezes about 3 times a day, that’s all.
Now, to business;
My working differential has been Trauma/FVR virus at the top since I’ve ruled out; neoplasia, cat leprosy, rodent ulcer, etc. (see previous posts).
Now, with the passage of time, I’m almost convinced it is caused by FVR/Feline Herpes virus, primarily because of the photo you see on this article, it looks almost identical to Princess;
https://pro.dermavet.com/feline-cutaneous-herpesvirus-clinical-and-therapeutic-aspects/
Compare that with the pictures of her, I’ve already posted in this thread.
Notice particularly the tiny black specks around her mouth and eyelids. I’ve highlighted them in RED.
They have been a constant feature, which I previously confused with food debris/blood from eager gobbling of her raw chicken and sardines meals.
But now I’m pretty sure they are the cellular debris (eosinophils and monocytes from Herpes (FHV-1) infected epidermal and mucosal cells from her lips and eyelids.)
So finally, +there’s my diagnosis+ (I feel better already!)
Feline Herpes poses no danger to humans, and my other healthy strays will have developed natural immunity long before “they found me”.
So towards a better treatment… The article suggests;
Q/
Antiviral Treatment:
Famciclovir currently represents the reference antiviral in the treatment of FHV-1 infection. Its administration at a dosage of 40 to 90 mg/kg two to three times daily has proven effective in controlling clinical manifestations. The duration of treatment must be adapted to clinical evolution and can extend over several weeks. Monitoring of renal function is necessary during treatment due to the molecule’s nephrotoxic potential.
Other Options:
Other molecules can be considered in the therapeutic strategy. Azithromycin, administered at a dose of 10 mg/kg once daily for 10 days, has shown some efficacy. Topical treatments, particularly daily application of acyclovir or imiquimod used two to three consecutive days per week, can usefully complement the systemic approach.
/Q
Which sounds hopeful, but I can’t get those medicines here in the mountains on the Burmese border.
Please can you help with that Dr. Krista?
1) Famciclovir (Nephrotoxic warning noted. I’ll need several weeks supply.)
2) Azithromycin
3) Acyclovir or Imiquimod.
Happy to pay the cost and postage to finally get this precious creature better. (PM/email me for postal address, and how to pay you.)
Colin
Colin Melbourne English missionary in Asia
https://www.born-again-christian.org/news/
Here’s an update on what “Princess” looks like today, after 3 months in my care.
Desperate for progress last week, I sedated her; cleaned up her face, trimmed her whiskers, and extracted all her remaining teeth, (there were 8, not four, with their roots, see snap attached,) just in case it’s an atypical case of “screaming cat-mouth”. Which is caused by feeding cats dry cat-food, and packets of Monsanto pet-sludge, instead of what Carnivores were created to eat: Raw meat and bone in the form of whole animals and arthropods.
She’s still a happy pussy, and eats whatever is put in front of her; suffers occasional calici/FVR snuffles, has mild pharyngitis, but her mandibular LN are now back to normal size, +BUT that nose ulcer is no better,+ and no worse.
Again, I could not palpate, or see, any polyps in her mouth or nasopharynx, but I don’t discount the likelihood of smaller polyps in her anterior nasal passages causing this. Perhaps as reaction to FVR, sting, trauma etc.
She’s still head-shy, it’s as tender as it looks, but she likes to rub her face with her front paws, and on objects, as though it itches.
I’ve ruled out neoplasia because she’s so well in herself, and her lymph nodes returned to normal after an antibiotic course.
Demodex, ringworm, and mange are common in strays here, and they’re easily cured with gentle application of home-made flours-of-sulphur and ivermectin creams. She’s had all that routine therapy, so I discount those. This is distinctly different from such cases.
The black specs are food remains, not scabs.
My differential diagnosis is now, in order of likelihood;
Nose trauma/FVR that has caused tiny nasal polyps.
Insect sting, spider, or snake bite inside her oral cavity, or on her face,
“Screaming cat-mouth” (aka. Commercial “pet food” toxicity. She could have lived on pet food poached from neighbours’ pets.)
Atopic allergy. (She licks her body fur all over, in long sessions until it’s wet with saliva, despite bathing and de-fleaing her.)
Cat leprosy, (Mycobacterium from rodents.)
Rodent ulcer (Ought to have resolved by now.)
Leishmaniasis. (Very rarely reported but present in SE Asia)
Suggestions for therapy welcome 🙂
Colin
Update Feb 1st. 2025:
This is the state of “Princess’s” nose on Feb. 1st 2025 compared with when I found her in early November 2024.
An example of one of those many conditions vets struggle with!
She’s bright, happy, and still eating whatever I offer her, but I’m keeping her on mainly raw chicken, as the lysine in the meat is supposed to have some antiviral activity. Her alimentary system is working perfectly. She has no teeth, but still manages to make short-work of raw chicken frames I chop up for her! (I could make a video of her eating one to post here, but it’d be a big file, and may overload your forum software.)
No cough despite the seasonally cold weather here in the mountains. I let her sleep with me indoors.
I give her three day courses of Amoxycillin and predisolone crushed in her food, now and then, when she appears snuffly and bunged up. I also clean her nose daily, and it seems to be less tender now. You’ll notice her left nostril is almost fully occluded in the latest picture, a baby-sized cotton-bud clears it, but makes it bleed, so I feel bad hurting her.
She’s putting weight on, and her mandibular LN are only slightly enlarged. Not surprising considering what we see here.
She still licks her fur all over, somewhat manically, she’s often soaking wet with saliva when I pick her up, and of course this symptom subsides when she’s on prednisolone.
My differential has not changed, and I welcome good advice.
Colin
Colin Melbourne English missionary in Asia
https://www.born-again-christian.org/news/
So my cat was diagnosed with upper respiratory about 4 months ago. Well he has been sneezing ,sounds nasally and , boogers just in the nasal area and the culture came back with pseudomonas well he is still lethargic and now won’t eat or drink now. He has been on orbax, nose drops, intrafungal medicine. Also he has a constant fever of 104°F. I am taking him to the vet tomorrow but wonder if it could be polyps? Pancreatitis?
Hello,
I think that if your cat isn’t responding as expected that it’s time to go back to the vet. I also think that you should talk about al of the other possible causes to his current clinical signs. A polyp is on the list of possible causes.
Good luck.
What other possibilities could you think why he is not eating and drinking?
Hi Dr. Magnifico,
Our adopted cat (former stray cat, now 100% indoor) has always shown all of the signs of a nasopharyngeal polyp (about 4 years now). I didn’t know what it was until I saw videos of cats with similar breathing noises and eventually saw your YouTube polypectomy videos.
Three short videos of his breathing sounds (turn up your volume) follow:
Called our vet for a surgeon referral, but they’ll only refer for a CT scan ($2000) before they’ll refer to a surgeon. Surgeon’s websites all indicate that they will only accept appointments by referral from a general Vet, so I can’t just make an appointment for examination by a surgeon (which I’m happy to pay for).
Bottom line, looking for a second-opinion / consult (happy to pay!) on whether it’s really necessary to do a $2000 CT scan *before* being referred to a surgeon for (a probably $2000) surgery. I’d rather just have a surgeon put the cat under anesthesia, go in, look for the polyp, and remove it if they see one. Happy to pay $2000 for just that surgery, even if it turns out there’s no polyp.
Thank you in advance for any response.
Hello,
I am sorry to hear about your dilemma. You are not alone. I know that a lot of people are in the same position that you are.
I am not sure how vetmed got to this place. I am not sure why so few veterinarians are willing to go and look for a polyp that if it continues to grow will kill, by suffocation, its host.
The idea that every single one of these cats needs a CT is incorrect. What every single one of these cats is is to breathe. Some of these cats will have polyps in places that we may not be able to get our hands on,, these cases may need a special scope to access. For this reason the price of care may increase.,, but for all of the cats I have seen I think I have given them a second chance at breathing, and a second chance at life.
Call every vet in your area. Try every single veterinary practice that is single doctor (therefore privately owned) and every practice that has some old guy (or girl) working there. I promise that every veterinarian over 50 knows how to, and already has experience with this. They can help.
If you cannot find anyone please come find me.
I will do my best to help.
Dr Magnifico
Thank you, Dr. Magnifico!
you are welcome,,, if you find someone to help you affordably please let me know
Hi, my cat has been sneezing and had a runny nose frequently recently. Her ears and gum also look pale. She’s underweight since before I pick him up from the street. May I know, what is going on with her? I am afraid to go to the vet because Im afraid I can’t pay the bill.
Unfortunately, diagnoses for things like this *cannot* be made over the internet. She needs to see a vet…especially if she’s been consistently underweight. She’ll need a full exam, with bloodwork and possibly a urinalysis.
I’m sorry. But if you refuse the vet, you’re furthering her illness. Please find a way to pay for it.
My dog has been sneezing frequently over the past few months. We are now noticing a small growth and change in shape on his nose as well? Any advice or help would be much appreciated, thank you!
-Mitch
There are numerous things this could be. Please call your vet and ask to be seen. I always start with an exam and a good history and then talk about potential possible causes and discuss rhe myriad of treatment options In some cases we chose an antibiotic. In others we talk about dental disease and it’s affect on the nose and discharge. We also talk about cancer and nasal flushing for foreign bodies. Even allergies are a possibility.
Please see a vet for which might be most likely in your dogs case.
Looking for information regarding polyps. In January of this year (2022) my then 3 1/2 year old cat developed what seemed like nasal congestion. She would snore, wheeze and “slurp” through her mouth. After 2 rounds of antibiotics they discovered she had a polyp under her soft pallet. After removal of the polyp her symptoms subsided a little but never completely. We then tried steroids but these did not help either. Now they are recommending I go to a specialist/internal medicine veterinary hospital to get a rhinoscopy and ct scan to see if there are additional polyps or some other kind of blockage. The initial consult visit would be $250 and the scoping and ct scan would cost $2500 to $3200. Is it common for cats to have more than one polyp and is there other treatments you would try before the very costly next step my vet is suggesting? I’ve already spent $1000 with what we have done so far so I am looking for any suggestions you can offer! I hate seeing her uncomfortable!! I should mention that she is not sneezing or coughing, but shake her head sometimes. She is eating fine and acting mostly fine except when lying down as that is when the difficulty breathing seems to get the worst.
Hello,
Without knowing your pet I would say the options are to recheck for the polyp (they can recur), try a barrage of medications to see if any help, or wait and see what happens , or see the specialist. There I’m not sure this is helpful but it’s the best I’ve got. Good luck
We have a very sassy beautiful 12 year old orange female tabby named Nala. She has been perfectly healthy until about a year ago when she started to sneeze a lot (that rapid-fire sneezing that cats do) and she started to make a snoring sound when she breathes. We initially thought it was just allergies but it didn’t get any better after several months. We took her to the vet and he diagnosed her with herpes and prescribed Chlorpheniramine 4mg crushed in her food. I’ve been giving her this for at least 6 months now and she has not improved. The sneezing has decreased, but the “snoring” has not improved at all. Searching online, we found a video of Dr. Magnifico performing surgery on a cat that had a nasal polyp and we are wondering if this may be what she has. The symptoms all seem to be the same as what she has been dealing with. So we’ve been searching for a vet in our area that performs this type of exam and surgery, and we have found this to be very expensive ($2000-$5000). She is otherwise a very healthy girl, she eats, drinks, uses litterbox and plays and snuggles all like normal. She has lost weight, but now seems to be putting it back on slowly. Dr. Magnifico’s office is only about an hour away and we would absolutely drive down to be able to have her exam Nala and if it is a reasonable price, have her remove the polyp if this was the diagnosis.
Hello
I’m sorry for the delay. If you would like a consult I would be happy to meet you and discuss options. Please call the clinic and ask for an appointment. It is the best place to start.
I have an 11-year old female domestic shorthair cat (Nala) who has been very healthy until around springtime last year when she started to develop a snorty sound when breathing and rapid sneezing fits. We figured it was maybe allergies at the time, as ours were really bad too. But it kept lingering and we finally asked our vet and he was reluctant to do a full exam on her because of the expense, and he also diagnosed her as having herpes, and prescribed Chlorpheniramine 4mg and Duralactin paste 2.5ml for her. I give her a 1/4 of the pill crushed in her canned food once a day, but the paste makes her sick. I have been giving her the pill for about 3 months now with zero improvement. I have been doing a lot of research, and the closest thing I could find that matches what she is dealing with is a video I found of Dr. Magnifico performing surgery on a cat for a nasal polyp. The description she gave completely matches what Nala sounds like with the snoring sounds when breathing and the constant sounds of trying to clear her throat. She has lost a lot of weight because I think it’s difficult for her to eat a lot but otherwise she acts like nothing is wrong, she is very playful, and also eats (best she can) and drinks normally, and litterbox habits are still great. My question is if this diagnosis sound like it could be correct, and if so, is this something that could possibly be fixed without breaking budget?
Hi!
Polyps in our kitty friends are quite common. I am a surgery technician that assists Dr.Magnifico and we have seen and removed more than a handful!
We have noticed not many vet offices check for polyps and typically it’s what we end up finding. (Not always the case as some cats are chronic upper respiratory forever)
This surgery is typically not a budget breaker. Please reach out and never be afraid to ask many questions to your veterinarian!, That’s what they are here for ,
Hi!
We always recommend reaching out to your vet or local shelters and asking about polyps. It is possible to have them removed, however we do see then reoccur in some cases(not all!!) With your cat being 11, your vet may want to dig a little further and see if there is anymore going on.
Hello,
I’m sorry to hear about your cat. I’m also sorry it’s so expensive to do these cases at referral centers.
If you have not looked for a polyp in the oropharynx yet I would start there. If you cannot afford the referral hospital and referral vet see if you can find a vet locally who will help. If you cannot afford find anyone locally I will do my best to help but I am not an internal medicine specialist and I don’t have a CT scanner. If the polyp can’t be found you may have no other options other than advanced diagnostics (CT or endoscopy).
Best of luck
Dr Magnifico